Kornimate/medical-research-clean huggingface dataset:
effect of transcranial direct current stimulation on sensory integration

Conditions: Diabetic Polyneuropathy

Summary: to determine the effect of transcranial direct current stimulation on sensory integration and risk of falling in diabetic polyneuropathy.

purpose: to determine the effect of transcranial direct current stimulation on sensory integration and risk of falling in diabetic polyneuropathy. background: diabetic polyneuropathy is the most prevalent chronic complication affecting 30% - 50% of diabetic patients. diabetic polyneuropathy usually affect the peripheral, autonomic, and central nervous systems with several clinical symptoms .about 80% of the cases of dn manifest as distal symmetrical sensorimotor polyneuropathy which is responsible for cases of chronic pain; impaired sleep quality; increase of the falling risk associated with weakness and increase of the risk of extremities amputation. transcranial direct current stimulation is neurophysiologic intervention that alters cortical excitability to enhance lower extremity somato-sensation and thus improve functional outcomes. hypotheses: there will be no effect of transcranial direct current stimulation on sensory integration and risk of falling in diabetic polyneuropathy

Eligibility criteria:
inclusion criteria: 1 - patient will be diagnosed as having diabetic polyneuropathy (dpn) and all patients have type ii diabetes. 2-the age of the patients ranged from 35 to 55 years. 3-clinically all patients suffered from glove stock hyposthesia, numbness and burning sensation and mild distal moror weakness 4-patients have sensorymotor peripheral neuropathy according to neurophysiological study to detect sensory and motor conduction velocity to confirm diagnosis. exclusion criteria: 1. history of diabetic ulcer and amputation . 2. osteoporosis. 3. fractures of lower limbs. 4. gross musculoskeletal problems eg:burn. 5. significant scar tissue or calluses on the feet. 6. peripheral vascular diseases (pvd) or microcirculation problems. 7. balance disturbance rather than diabetic peripheral neuropathy as ear problems, labrynthinitis, stroke or cerebellar problems. 8. visual disturbance. 9. autonomic neuropathy. 10. advanced osteoarthritis of lower limbs. 11. nerve root compression (radicuolopathy) affecting lower limbs. 12. patients with implanted devices for pain control such as deep brain
prp treatment of osteoarthritic knee with a new autologous blood product (cytorich)

Conditions: Osteoarthritis of the Knee

Summary: this study is aimed at evaluating the efficacy and safety of cytorich compared to platelet-rich plasma (prp) in alleviating pain and improving function in subjects with knee oa.

this active-controlled, randomized, double-blind, prospective study will enroll subjects with knee oa. subjects will be randomized equally to treatment with 4 injections of abp (test treatment) or 4 injections of prp (active control).

Eligibility criteria:
inclusion criteria: * radiographic confirmation of oa in the knee and screening knee pain score of \>50 mm on a 100 mm visual analog scale (vas) for at least one knee. exclusion criteria: * female who is pregnant, lactating, or unwilling to use adequate contraception during the clinical study. * subject who had viscosupplementation within 3 months of screening. * subject treated with non-steroidal anti-inflammatory drugs (nsaids) within 72 hours of screening. * subject who received steroid treatment within 8 weeks of screening. * subject who had an acute disease or trauma within 6 weeks of screening. * subject with any major surgery, arthoplasty or arthroscopy in the target knee or lower extremities within 6 weeks of screening (or any planned surgeries throughout the duration of the study). * subject with a major dysplasia or congenital abnormality of the knee or a condition which may affect the knee (i.e., osteonecrosis, chondrocalcinosis). * subject with a primary inflammatory arthropathy (i.e., rheumatoid arthritis, psoriatic arthritis, gouty arthritis). * subject with knee joint infection, skin diseases, or infections in or near the area of injection. * subject with any musculoskeletal condition that would impede measurement of the effectiveness at the knee (in particular symptomatic hip oa). * subject with any claudication or peripheral vascular disease. * subject with active malignancy or that has been in treatment for a malignancy within the past 3 years. * subject with uncontrolled diabetes mellitus, diabetic neuropathy, or complications from infection. * subject with known sensitivity to citric acid. * subject taking oral or parental anticoagulant therapy other than acetylsalicylic acid 325 mg per day or less. * subject with active disease that may require periodic treatment with systemic steroids during the study period. * subject with other diseases or conditions as assessed by the investigator that may limit the ability to perform necessary study evaluations (e.g., active alcohol abuse, active drug abuse, significant psychiatric or neurological disorders, planned relocation, etc.) or any other factors (e.g., ongoing litigation for workers compensation for musculoskeletal injuries or disorders) that may compromise the subject's ability to participate in this study
parkinson's disease exercise tms pet study

Conditions: Parkinson Disease

Summary: the therapeutic effects of exercise in parkinson's disease (pd) are commonly reported, however the mechanisms are unknown. the purpose of this study is to investigate the potential mechanisms of exercise in the brain for the treatment of pd.

positron emission tomography will be used to measure dopamine neuron density, endogenous dopamine release and neuroimflammation. we will also use functional magnetic resonance imaging (fmri) to measure brain activity. assessments will be conducted before and after a 12-week exercise intervention and 3-year follow-up. participants will be randomly allocated into either an aerobic or a stretching intervention. clinical measures of motor function, cognition and mood will also be assessed.

Eligibility criteria:
inclusion criteria: diagnosed with parkinson's disease, exercise less than 3x per week. exclusion criteria. describe which potential participants will be excluded from participation, and list the criteria for their exclusion. 1. atypical parkinson syndrome (progressive supranuclear palsy, multiple system atrophy, drug-induced etc.); 2. significant osteoporosis or arthritis; 3. other neurological disease/complications (e.g. myopathy, stroke, brain lesion, ms); 4. self-reports claustrophobia; 5. history of cancer within 5 years of study participation; 6. high dose of radiation from other procedures within the year; 7. not able to tolerate being off pd medication for up to 24 hours; 8. a female subject who is breast-feeding or pregnant. 9. subjects who regularly use anti-inflammatories (only excluded for pbr scans). exclusion criteria for mri scanning and magnetic stimulation from repetitive transcranial magnetic stimulation (rtms) scanning includes: 1. artificial heart valve; 2. brain aneurysm clip; 3. electrical stimulator for nerves or bones; 4. ear or eye implant; 5. implanted drug infusion pump; 6. coil, catheter, or filter in any blood vessel; 7. orthopedic hardware (artificial joint, plate, screws); 8. other metallic prostheses; 9. shrapnel, bullets, or other metal fragments; 10. surgery or tattoos (including tattooed eyeliner) in the last six weeks; 11. brain surgery 12. have a cardiac pacemaker, wires or defibrillator; 13. have had an injury where a piece of metal lodged in the eye or orbit; 14. have a ferromagnetic aneurysm clip; and 15. have a history of seizures/epilepsy 16. history of severe or uncontrolled headaches/migraines 17. taking medications that lower seizure threshold (e.g. amitryptiline, haloperidol) subjects may be excluded following study enrollment if they meet any of the following exclusion criteria: 1. significant cognitive impairment or depression; 2. significant or unstable cardiovascular or respiratory disease - all subjects will undergo a screening exercise bicycle stress test; or 3. failure to comply with the exercise or stretching intervention program by not completing at least 30 of the 36 exercise classes. 4. severe/multiple head trauma(s)

Keywords: positron emission tomography dopamine parkinson's disease
observation of bevacizumab plus front-line chemotherapy in patients with ovarian cancer

Conditions: Ovarian Cancer

Summary: investigators propose to assess,the safety and tolerability profile (number of participants with adverse events) of bevacizumab (avastin) when added to chemotherapy as front-line treatment of epithelial ovarian cancer, fallopian tube carcinoma or primary peritoneal carcinoma

in the last decade, clinical studies with bevacizumab (avastin) in various tumors have shown encouraging results in terms of efficacy/safety. however there is no data generated in greek population with regards to safety and efficacy of bevacizumab in front line ovarian cancer. two prior global phase iii randomized trials showed that the addition of concurrent bevacizumab to standard chemotherapy and maintenance bevacizumab significantly increased the pfs in patients with advanced ovarian cancer it would be relevant to document the real life clinical data of bevacizumab in combination with chemotherapy (paclitaxel/carboplatin) in front line ovarian cancer as prescribed by the medical oncologists in greece.

Eligibility criteria:
inclusion criteria: * written informed consent * age ≥18 years * histologically confirmed advanced stage iii (suboptimally debulked \>1cm of residual disease) or stage iv ovarian cancer fallopian tube carcinoma or primary peritoneal cancer following surgical debulking with the aim of maximal surgical cytoreduction * one or more measurable lesions (≥1cm in diameter with spiral ct scan or ≥2cm with conventional techniques) according to recist criteria * ecog performance status ≤2 * adequate haematological, renal and hepatic function * urine protein \<2+ (dipstick) * life expectancy of \>12 weeks exclusion criteria: * previous front line treatment for ovarina cancer * previous radiotherapy to target lesions * patients with brain metastases and/or cancerous meningitis * presence or history of other neoplasm except properly treated basal cell skin cancer or in situ cervical carcinoma * patients participating in interventional clinical trial

Keywords: ovarian cancer chemotherapy anti-angiogenic agent bevacizumab front line
ngs and tme for evidence-based treatment of pancreatic cancer

Conditions: Pancreatic Ductal Adenocarcinoma

Summary: the tumor tissue of patients with pancreatic cancer will be submitted to next-generation sequencing (ngs) and these data will be evaluated with an oncology treatment decision support (tds) software tool that is a medicinal product class 1 (ce-marked). this software will make evidence-based suggestions for drugs likely to be effective, ineffective, or toxic (fda approved biomarkers). for patients fit for second-line therapy, the resulting recommendations will be judged by the tumor board.

tumor tissue of patients (surgical resection, biopsy) will be used for swedac-certified dna extraction and ngs. pseudonymised sequencing data will be fed into a tds software tool (treatmentmap™, molecular health) and based on published evidence, suggestions will be made, graded into nccn categories of approved drugs in indication or otherwise, clinical evidence or experimental. same with anticipated inefficacy. in addition, fda-approved biomarkers for toxicity will be analysed. this information is taken to the tumor board for making a decision whether this information is useful and eventually to recommend a treatment for a given patient.

Eligibility criteria:
inclusion criteria: * patient age ≥ 18 years up to 75 years * patient willing and able to provide informed consent * treatmentmap™ ngs/tme is ordered by the tumor board (mdt) under routine clinical practice * diagnosis of a locally advanced, inoperable or metastatic pancreatic carcinoma, clinically and histologically verified according to the currently prevailing standards. * patient received first line therapy according to applicable guidelines and/or standards (soc) * sufficient testing material available (e.g. tumor biopsy) to allow ngs/tme ngs panel testing. exclusion criteria: * patients with ongoing systemic infection, * patients with immunodeficiency, * patients with severe cardiovascular and pulmonary morbidity that might interfere with or preclude further systemic anticancer treatment, * patients on full therapeutic anticoagulation. * patients who, due to their clinical status, are not eligible for further systemic anticancer therapy (chemotherapy, immunotherapy etc.) * patients who, due to their disease status are in need of immediate therapy and cannot wait for the result of the ngs/tme process.
pilot study assessing the effect of tildrakizumab in vitiligo

Conditions: Skin and Connective Tissue Diseases; Skin Diseases; Pigmentation Disorder; Hypopigmentation; Biologic; Vitiligo

Summary: vitiligo is a common acquired depigmentation disorder affecting approximately 2% of the world population. the purpose of this pilot study is to evaluate the effect and the safety of tildrakizumab in adult participants with vitiligo.

tildrakizumab is a monoclonal antibody against interleukin (il) 23, specifically anti-il23p19. it is approved in the usa, europe and australia for psoriasis. the psoriasis dose is 100mg administered subcutaneously at weeks 0, 4 and every 12 weeks. recent research has shown medications used to treat psoriasis may be effective in other immune mediated or autoimmune diseases such as vitiligo. with studies underway assessing the effect of janus kinase (jak) inhibitors in psoriasis and vitiligo, this study seeks to determine if an il-23 inhibitor is beneficial in halting disease progression and inducing repigmentation in vitiligo. there is some data to indicate that a higher dose of tildrakizumab is effective for other autoimmune diseases such as psoriasis and hidradenitis suppurativa. for psoriasis, 200mg dosage was more effective than 100mg dosage. for hidradenitis suppurativa, a dosage of 200mg every 4 weeks was shown to be effective. patients included in this study will start tildrakizumab at a dosage of 200mg every 4 weeks for 6 months. there is a total of 8 visits involved in this study. tildrakizumab is provided during visit 2, 3, 4, 5, 6, 7. visit 1is a screening visit. at visit 1 and visit 8 no study drug will be provided.

Eligibility criteria:
inclusion criteria: * 18 years of age or older * diagnosis of vitiligo * clinically stable vitiligo: defined as no new vitiligo patches and no enlargement of existing patches in previous 3 months. * able to provide voluntary, written, informed consent exclusion criteria: * clinically active vitiligo: defined as new vitiligo patches or enlargement of existing patches in previous 3 months * concurrent skin disease in the study area * immunocompromise * women of childbearing potential (wocbp) who are unwilling to practice highly effective contraception prior to the initial dose/start of the first treatment, during the study, and for at least 12 weeks after the last dose.

Keywords: tildrakizumab non-segmental vitiligo interleukin-23 il-23 biological treatment pilot study anti-inflammatory agents anti-inflammatory agents, non-steroidal vitiligo
treatment of the overactive bladder syndrome: a delphi study

Conditions: Overactive Bladder Syndrome

Summary: idiopathic overactive bladder syndrome (ioab) is a prevalent condition in urological practice. the variability in management between specialists and between centers remains high. even guidelines are not always clear on the treatment management of drug therapy resistant oab. standardization in oab treatment is needed.

guidelines on the overactive bladder syndrome (european association of urology, american urology association and international consultation on incontinence) are comparable but remain vague mainly on the level between conservative and major surgery. they do not specify combinations of medications and do not distinguish between intradetrusor botulinum toxin injections (btx) and sacral neuromodulation (snm) because of lack of evidence. to reduce the variability in the treatment management of oab, standardization is needed. by use of a delphi technique, the current perception of belgian urologists towards the most appropriate treatment approach for idiopathic oab (ioab) was explored. based on these results a practical treatment algorithm for its use in daily clinical practice could be developed.

Eligibility criteria:
inclusion criteria: * profession: md, urologist * member of the working group of functional urology exclusion criteria: * retirement * non-operative as an urologist.

Keywords: overactive bladder syndrome delphi study treatment algorithm
paroxetine and interpersonal psychotherapy for maintaining health and well-being in elderly individuals with depression

Conditions: Unipolar Depression

Summary: this study will evaluate the effectiveness of paroxetine versus interpersonal psychotherapy and a combination of the two in helping elderly patients with depression remain well and improve quality of their lives.

this is primarily a study of maintenance therapies, not a study of acute therapeutic efficacy, in late-life major depression. the study aims to identify factors that encourage maintenance of treatment gains and to identify which patients need which kinds of treatment to remain well. the following questions are to be addressed: * is the probability of recurrence different among the treatment groups? * what variables may be related to, or predictive of, differences among groups? * after 1 to 2 years of maintenance therapy, will patients assigned to maintenance combined treatment with both paroxetine and interpersonal psychotherapy remain well at higher rates than patients assigned to paroxetine alone, interpersonal psychotherapy alone, or placebo? * will the time to recurrence differ across treatment groups, and what variables may be related to, or predictive of, time to recurrence? the major study hypothesis is that combined treatment with paroxetine and interpersonal psychotherapy will be superior to either treatment alone (and to placebo) in preventing recurrence of major depressive episodes in patients aged 70 and above. for information on related studies, please follow these links: http://clinicaltrials.gov/show/nct00000377 http://clinicaltrials.gov/show/nct00177671

Eligibility criteria:
inclusion criteria: * age 69 or older * meets dsm-iv criteria for current unipolar major depression * hrsd (17 item) score of 15 or higher * folstein mini mental status exam score of 18 or higher exclusion criteria: * lifetime diagnosis of any psychotic disorder or bipolar disorder * alcohol or drug abuse within the past six months * mattis dementia rating score of 120 or less * contraindication to ssri therapy * hyponatremia

Keywords: depression elderly late life
incontalert: machine learning algorithms for individual bladder filling level prediction

Conditions: Monitoring of the Bladder Filling

Summary: the aim of this study is to evaluate the bladder filling level of the study participants using the incontalert sensor. the generated data will be used for the evaluation and optimization of the machine learning algorithms to be able to make precise predictions about the individual bladder fill level. in particular, the hypothesis that the bladder filling level can be estimated by the algorithm will be tested. when testing the hypothesis, it should be determined which deviation (measured by the mean absolute percentage error) of the estimation/prediction differs from the actual value (obtained by measuring the urine output using a measuring cup in combination with kitchen scales).


Eligibility criteria:
inclusion criteria: * informed consent exclusion criteria: * missing informed consent

Keywords: bladder monitoring digital health bladder filling level incontinence neurourology neurogenic bladder spinal cord injury
prognostic factors in malignant gi bleeding treated with hemostatic powder

Conditions: Death

Summary: this is a retrospective study to identify the prognostic factors of the good outcomes in patients who presented with upper gi bleeding from tumor and received hemospray via endoscopy for hemostatic control. the good outcomes were assessed by immediate hemostasis, rebleeding at 72 hours as well as 7, 14 and 30 days following presentation at initial bleeding episode and also 6-month survival rate.

tumor-related gastrointestinal (gi) bleeding is increasing due to the advancement of treatment in oncology. however, conventional endoscopic hemostatic methods are not reliable to control bleeding. surgery, embolization, and radiotherapy can served as the salvage hemostasis; though, a bridging endoscopic therapy is required during resuscitation and stabilization of the patients. hemospray is a recent novel endoscopic hemostatis powder which has a trend to be an effective instrument for controlling the active upper gi tumor bleeding from a match-pair, case-control study by the author's recent publication. consequently, the authors hypothesized that there are some prognostic factors related to the outcome of hemospray treatment in tumor bleeding.

Eligibility criteria:
inclusion criteria: * all patients seen in the emergency room and/or hospitalized for malignant gastrointestinal haemorrhage from 2011 to 2017 exclusion criteria: * age \< 18 years
low dose dexmedetomidine versus ketamine in multiple fracture ribs

Conditions: Rib Fractures

Summary: in our study, we assess the diaphragmatic function, pain quality and anti-inflammatory properties between low dose infusion of dexmedetomidine and ketamine in patients with multiple fracture ribs on conservative treatment.

a written informed consent from patients or thier legal guardians, patients will be assigned randomly to three groups (30 subjects each) with traumatic multiple fracture ribs 3 ribs or more. after thoracic epidural is inserted, the drug study intervention will be started and run for 5 days during icu admission. in (group d) low dose dexmedetomidine infusion 0.2 µ/kg/hour iv for 5 days. in (group k) low dose ketamine infusion 2.5 µ/kg/min for 5 days. in (group c) the same dose and duration of normal saline will be given.

Eligibility criteria:
inclusion criteria: * adults (age 18-65 years) of american society of anaesthesiologists (asa) physical status i-ii * traumatic multiple fracture ribs 3 ribs or more, who will be subjected to thorough assessments including chest 3d-ct * undergoing conservative treatment (chest strappings) * intractable pain with visual analogue scale (vas) over 6 after traditional therapies * glasgow coma scale (gcs) ≥ 13. exclusion criteria: * multiple traumas to body parts other than chest with an abbreviated injury scale over 3 * serious head trauma with a glasgow coma scale lower than 13 * mechanically ventilated patients * massive hemothorax * injury to the trachea or bronchus with requirement for immediate surgery * dementia * use of corticosteroids during icu stay * sepsis * continued use of neuromuscular blocking agents and aminoglycosides antibiotic use as they are known risk factors for icu-acquired weakness and any known hypersensitivity * contraindication to the study drugs.